Sleeping issues? Could be the size of your tongue and tonsils.

Dentists may not be able to diagnose Obstructive Sleep Apnea (a disorder in which breathing repeatedly stops and starts during sleep due to blocked upper airways) right off, but a new study out of University of Buffalo School of Dental Medicine, dentists can now spot possible signs and send them to a sleep medicine specialist. This puts dentists on the front lines of finding out why a patient may not be able to sleep.

According to the study, oversized tonsils and tongue indention ( teeth imprints along the tongue that indicate that it is too large for the mouth) placed a patient at higher risk of obstructive Sleep Apnea. Obese patients were almost 10 times more likely to report OSA symptoms than non-obese patients. Sleep apnea affects more than 18 million American adults, but many cases go undiagnosed, according to the National Sleep Foundation. Severe cases of the disorder are linked to cardiovascular disease, diabetes, depression, memory loss and more.

Analyzing 200 patients at the dental clinics at the University of Dammam’s College of Dentistry in the Kingdom of Saudi Arabia, the researchers tested participants for OSA using the Berlin Questionnaire, a validated assessment used to screen people for OSA. Participants were then screened for potential risk factors of OSA, such as weight, neck circumference, blood pressure, and size of the tongue, tonsils, and uvula– the tissue that hangs in the back of the throat. The results found that 23 percent of participants were at risk for OSA, of which nearly 80 percent were male. The factors most common among people who were identified as high risk for OSA on the Berlin Questionnaire – along with obesity – were large tonsils, tongue indentations, and a high Epworth Sleepiness Scale score, another questionnaire used to measure daytime sleepiness.